Abstract
PURPOSE: This study evaluates the efficacy of minimal vitrectomy for full-thickness macular hole (FTMH) repair using a triamcinolone acetonide (TA)-IVIZ patch and balanced salt solution (BSS) tamponade. METHODS: An in vitro experiment was conducted to compare the adhesiveness and stability of the TA-IVIZ patch and the TA-DisCoVisc patch. Although the clinical arm of the study was a prospective study, an interventional cohort study was then performed on 24 eyes from 23 consecutive patients with FTMH. All eyes underwent minimal vitrectomy combined with internal limiting membrane (ILM) peeling, an inverted ILM flap, TA-IVIZ patch application, and BSS tamponade, without postoperative prone positioning. Outcomes, including anatomical closure rate, best-corrected visual acuity, and intraoperative and postoperative complications, were compared with a retrospective cohort of 25 eyes from 24 patients who underwent conventional surgery involving ILM peeling and grafting, gas tamponade, and postoperative prone positioning. RESULTS: The in vitro experiment demonstrated that TA-IVIZ exhibited stronger adhesion than the TA-DisCoVisc. The anatomical closure rate was comparable between groups (87.5% for TA-IVIZ vs. 92% for gas tamponade; P = 0.888), as were final best-corrected visual acuity improvements (P = 0.954) and mean postoperative intraocular pressure (P = 0.623). Notably, the TA-IVIZ group did not require postoperative prone positioning. CONCLUSIONS: Minimal vitrectomy with ILM peeling, an inverted ILM flap, TA-IVIZ patch, and BSS tamponade achieves high closure rates, reduces the requirement for postoperative prone positioning, and facilitates faster visual recovery, presenting a promising alternative to conventional gas tamponade techniques. TRANSLATIONAL RELEVANCE: We combined TA and IVIZ to provide an effective alternative to conventional techniques for the treatment of FTMH.